Scarring from sexually transmitted infections, injury, or surgery
Toxins in the environment
Vasectomy or failure of vasectomy reversal
Healthy couples under age 30 who have sex regularly will have a 25-30% per month chance of getting pregnant each month.
A woman is most fertile in her early 20s. After age 35, the chance a woman can get pregnant drops greatly after age 35 (and especially after age 40). The age when fertility starts to decline varies from woman to woman.
Exams and Tests
Deciding when to get treated for infertility depends on your age. Doctors often suggest that women under 30 try to get pregnant on their own for 1 year before getting tested.
Infertility testing involves a medical history and physical exam for both partners.
Blood and imaging tests are most often needed. In women, these may include:
Blood tests to check hormone levels, including progesterone and follicle stimulating hormone (FSH)
Measurement of body temperature every morning to see if the ovaries are releasing eggs
Medicines to treat infections and clotting disorders
Medicines that help the growth and release of eggs from the ovaries
Couples can increase the chances of becoming pregnant each month by having sex at least every 3 days before and during ovulation.
Ovulation occurs about 2 weeks before the next menstrual cycle (period) starts. Therefore, if a woman gets her period every 28 days the couple should have sex at least every 3 days between the 10th and 18th day after her period starts.
Having sex before ovulation occurs is especially helpful.
Sperm can live inside a woman's body for at least 3 days.
However, a woman's egg can only be fertilized by the sperm for a few hours after it is released.
Women who are under or overweight, may increase their chances of becoming pregnant by getting to a healthier weight.
Many people find it helpful to take part in support groups for people with similar concerns. You can ask your health care provider to recommend local groups.
As many as 1 in 5 couples diagnosed with infertility eventually become pregnant without treatment.
More than half of couples with infertility become pregnant after treatment. This figure does not include advanced techniques such as in vitro fertilization (IVF).
When to Contact a Medical Professional
Call your health care provider if you are unable to get pregnant.
Preventing sexually transmitted infections (STIs), such as gonorrhea and chlamydia, may reduce your risk of infertility.
Maintaining a healthy diet, weight, and lifestyle may increase your chance of getting pregnant and having a healthy pregnancy.
American Society for Reproductive Medicine. Diagnostic evaluation of the infertile female: a committee opinion. Fertil Steril. 2012;98:302-307.
American Society for Reproductive Medicine. Diagnostic evaluation of the infertile male: a committee opinion. Fertil Steril. 2012;98:294-301.
Bulun SE. Physiology and pathology of the female reproductive axis. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology. 12th ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 17.
Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.